• Form

  • Format: 0000 000 000.
  • Date of Birth*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Gender*

  • Medical Screening

  • Has your medical practitioner ever told you that you have a heart condition or have you ever suffered a stroke? If yes, please seek advice from a doctor before commencing training.*
  • Do you ever experience unexplained pains or discomfort in your chest at rest or during physical activity/exercise? If yes, please seek advice from a doctor before commencing training.*
  • Do you ever feel faint, dizzy or lose balance during physical activity/exercise? If yes, please seek advice from a doctor before commencing training.*
  • Have you had an asthma attack requiring immediate medical attention at any time over the last 12 months? If yes, please seek advice from a doctor before commencing training.*
  • If you have diabetes (type 1 or 2) have you had trouble controlling your blood sugar (glucose) in the last 3 months? If yes, please seek advice from a doctor before commencing training.*
  • Do any of the following apply to you?*

  • Full terms can be found here. Please ensure you are aware of my full policies, including rescheduling, pausing, and billing. Selected policies are summarised below for your convenience. 

    Rescheduling sessions: Individual sessions can be rescheduled until 6pm the day before the session otherwise the session is forfeit. Team training sessions can be rescheduled within a week at Sam’s discretion. 

    Cancellations and Pausing Training: Services can be cancelled or paused until 6pm Thursday the week before otherwise full fees apply for that week.

    Billing: Payment for all sessions must be made by the Friday before the session. 

    Risk: I acknowledge that participating in this activity may involve a risk of serious injury or even death from various causes including over exertion or accidents with equipment and surroundings. I assume the risk and responsibility for any injury, death or property damage resulting from my participation in this activity.

  • Goals and Feedback

    Please reflect on our conversations and sessions so far and share your thoughts.

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